{"id":1393,"date":"2013-10-11T07:06:34","date_gmt":"2013-10-11T07:06:34","guid":{"rendered":"http:\/\/jacobimed.org\/NS\/?page_id=1393"},"modified":"2013-10-11T07:06:34","modified_gmt":"2013-10-11T07:06:34","slug":"periop-diabetes-mgmt-cases","status":"publish","type":"page","link":"https:\/\/jacobimed.org\/old\/ambulatory\/mlove\/curriculumconsult-specialties\/periop-endo-liver-renal\/periop-diabetes-mgmt-cases\/","title":{"rendered":"Periop Diabetes Mgmt Cases"},"content":{"rendered":"

Perioperative<\/span><\/span> Diabetes Management
\nCases<\/span><\/p>\n

\n

\u00a0<\/span><\/p>\n

1.\u00a0 <\/span>A type II
\ndiabetic is going for a surgery.\u00a0 <\/span>What
\ninformation do you need to recommend proper diabetes
\nmanagement?<\/span><\/p>\n

\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

2.\u00a0 <\/span>You are
\nasked at 6 p.m. by the orthopedics service to “clear” an 80 year-old woman with
\ntype II diabetes for an ORIF of her hip sometime tomorrow.\u00a0 <\/span>The patient normally takes glyburide<\/span> 10 mg bid, metformin<\/span>
\n1000 bid, actos<\/span> 45 mg qd<\/span>,
\nand Lantus<\/span> 30 U qhs<\/span>.\u00a0 <\/span>Her last HbA1c was 7.3%.\u00a0 <\/span>She has had a few episodes of hypoglycemia
\nwith sugars in the 50’s at home, which she self-treated with orange juice.\u00a0 <\/span>Currently fingerstick<\/span> glucose is 250.
\n<\/span>She will be overnighted<\/span> in the surgical
\nstep-down unit and kept NPO.
\n<\/span><\/span><\/p>\n

\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

3. Urology refers an<\/span> 65
\nyear-old man to you for preoperative consultation.\u00a0 <\/span>He will be going for TURP in three
\nweeks.\u00a0 <\/span>The patient takes metformin<\/span> and glyburide<\/span> and has
\nHBA1c of 8.8%.\u00a0 <\/span><\/span><\/p>\n

\u00a0<\/span><\/p>\n

\u00a0<\/span><\/p>\n

4. Vascular Surgery pages you to recommend diabetes
\nmanagment<\/span> for a 70 year-old woman going for a transmetatarsal<\/span> amputation for gangrenous toes in the
\nmorning.\u00a0 <\/span>The patient is a brittle type
\nII diabetic who’s current home regimen is 50 U NPH with 15 R in the am and 40 U
\nNPH with 15R before dinner.\u00a0 <\/span>She tells
\nyou her sugar is “up and down.”\u00a0 <\/span>Her
\nhusband provides fingerstick<\/span> log.\u00a0 <\/span>The patient varies from fingersticks<\/span> in the 50’s to fingersticks<\/span> in the 300’s without apparent pattern.\u00a0 <\/span>Current fingerstick<\/span>
\nis 80.<\/span><\/p>\n<\/div>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Perioperative Diabetes Management Cases \u00a0 1.\u00a0 A type II diabetic is going for a surgery.\u00a0 What information do you need to recommend proper diabetes management? \u00a0 \u00a0 2.\u00a0 You are asked at 6 p.m. by the orthopedics service to “clear” an 80 year-old woman with type II diabetes for an ORIF of her hip sometime….<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":1391,"menu_order":0,"comment_status":"open","ping_status":"open","template":"","meta":{"_bbp_topic_count":0,"_bbp_reply_count":0,"_bbp_total_topic_count":0,"_bbp_total_reply_count":0,"_bbp_voice_count":0,"_bbp_anonymous_reply_count":0,"_bbp_topic_count_hidden":0,"_bbp_reply_count_hidden":0,"_bbp_forum_subforum_count":0,"footnotes":""},"class_list":["post-1393","page","type-page","status-publish","hentry"],"_links":{"self":[{"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/pages\/1393","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/comments?post=1393"}],"version-history":[{"count":1,"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/pages\/1393\/revisions"}],"predecessor-version":[{"id":1396,"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/pages\/1393\/revisions\/1396"}],"up":[{"embeddable":true,"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/pages\/1391"}],"wp:attachment":[{"href":"https:\/\/jacobimed.org\/old\/wp-json\/wp\/v2\/media?parent=1393"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}